Typhoid fever in Karbala Governorate, an epidemiological study

Mansoor Jasim Al-Ameri, Ali; Mohammed Hashem AL- Araji, Emtenaa

	Typhoid fever in Karbala Governorate, an epidemiological study
Kerbala Journal of Medicine
Article 1, Volume 5, Issue 12, 2012, Pages 1406-1412 PDF (0 K)
Authors
Ali Mansoor Jasim Al-Ameri; Emtenaa Mohammed Hashem AL- Araji
Abstract
Abstract ackground:Typhoid fever is a common systemic illness caused primarily by infection with Salmonella typhi. It could be diagnosed depending on classic clinical features supported by serologic and bacteriologic demonstration. It is well known that this disease is characterized by sharp seasonal variation in addition to many other factors affecting its prevalence in the population. These factors may include age, residence, psychosocial status and certain environmental conditions. Study design and objective: This is a cross sectional epidemiological study. It was done during August, 2008 through July, 2009 in Karbala. It aims to isolate and identify Salmonella typhi from blood samples collected from clinically suspected cases to predict the diagnostic value of the clinical suspicion versus the bacteriologic investigation including isolation and characterization of the main causative pathogen, Salmonella typhi. Also it aims to determine the effect of age, gender, educational level and seasonal variation on the frequency distribution of typhoid fever duringthe study period. Method: Blood samples were collected from 718clinically suspected patients (355 males and 363 females) who attended Al-Hussein Teaching Hospital and Pediatric teaching Hospital in Karbala with signs and symptoms of typhoid fever (proven by specialist physician/pediatrician). Blood was cultured in enriched, selective and differential media to isolate the causative agent, Salmonella typhi and was confirmed by some specific biochemical tests. Results:Of the 718 blood samples, only379 (~52.8%) gave positive blood culture for Salmonellatyphi proven by specific biochemical tests. The percentage of infected patients according togendershowed non significant difference (males ~45.8% compared with females ~54.2%). Similarly, when incidence compared in terms of standard of education, it was (46.4% among educated versus 53.6% uneducated). Additionally, frequency distribution of infection in terms of different age groups showed significantly higher infection rates in age groups 5-14 and 15- 45 years than others (recording 28.21% and 46.58%, respectively).Regarding seasonal variations, the infection rates were recorded to be peaked in June recording 19.22% from the B Typhoid fever in Karbala Governorate… Emtenaa Mohammed Hashem kerbala J. Med. Vol.5, No.2, Dec, 2012 9641Page annual infection rates, while the lowest rate was recorded inFebruary (1.81%) indicating a highly significant difference (p-value <0.01). Conclusion: According to the study data, it was concluded that only about half the clinically suspected cases of typhoid fever give positive blood culture results for the main causative pathogen, Salmonella typhi. Also, it was shown that there is no significant effect of gender and education standard on rate of infection with typhoid fever. However, seasonal variation and age significantly affect this rate. Key words: Typhoid fever, Salmonella typhi, epidemiology, bacteriologic diagnosis, clinical suspicion.

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